Japan International Cooperation Agency (JICA) and Fiji’s Ministry of Health marked the close of the Non Communicable Diseases Phase 2 (NCD2) Project with a final dissemination seminar earlier this month, presenting outcomes and lessons intended to shape the country’s long-term response to an epidemic that accounts for an estimated 80 percent of deaths nationally.
Project lead Keiko Nagai told seminar attendees the second phase moved beyond the Central Division pilot used in Phase 1 and was rolled out nationwide after the trial proved effective. As the programme scaled up, teams made several operational changes to keep the work practical for frontline staff. “We found that the approach was effective, but during the project we also realised that some adjustments were needed,” Nagai said, noting standard operating procedures were revised to reduce additional workloads and streamline screening and follow-up tasks for nurses and medical officers.
NCD2 also produced a structured monitoring framework designed to preserve oversight as activities expand. Follow-up and review operate at two levels: an operational tier where project implementing committees — made up of sub-divisional medical officers, nurse unit managers and divisional health leaders — assess performance in their areas, and a national joint coordinating committee chaired by the permanent secretary for Health that provides high‑level accountability. Nagai described the dual system as “a strong model for ensuring accountability for the project’s outcomes and impact.”
At the seminar, Dr Devina Nand, head of Wellness at the Ministry of Health and Medical Services, stressed that national data showing high prevalence of NCD risk factors drove investment from development partners and underpinned domestic commitment. She said the ministry had funded a substantial portion of implementation activities during NCD2, a deliberate move aimed at financial sustainability. “We are proud that a lot of the implementation was paid for by the ministry itself. Financially, sustainability is something we can maintain,” Dr Nand said, while cautioning that continued investment in human resources remains essential.
Dr Nand identified specific workforce needs that will determine the programme’s durability: technical leaders to deliver motivational interviewing, run workplace health promotion and maintain wellness monitoring systems. Those skills, she said, are critical if the gains of the project are to be translated into persistent service improvements rather than a short‑lived donor initiative.
Another outcome highlighted at the seminar was growing community ownership of health. Senior consultant Dr Yoshihisa Yamazaki said grassroots understanding that individuals can manage their own health was one of the most encouraging legacies of NCD2. “Autonomy has been established, and even after the project finishes, I believe the activities will continue steadily,” he said, indicating community-level activities and peer support mechanisms are likely to persist beyond formal project funding.
The seminar represents the latest development in a multi‑phase effort to strengthen Fiji’s NCD prevention and control systems. With a nationwide monitoring architecture in place and the ministry already co‑financing key elements, officials say the transition will test whether investment in people and locally owned systems can sustain the programme’s outcomes now that the project phase has concluded.
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